Biceps Tendon Tear ?

[Dreamliner]

Don't worry, I'm not asking anyone to play doctor. And I'm going to see an ortho this week. Just wondering if anyone has seen anything like:

Yellow bruising at front of shoulder. Only slight discomfort. No range-of-motion issues.

Context: have had niggling pains in the area for awhile now. A few days ago I slammed that very area into the doorframe. It smarted but I didn't notice any bruising. It did sting a bit though. Friday did my handstand pushups. Today I did my one-arm pushup progressions and noticed the bruising in the mirror afterwords. Am icing it and took an anti-inflammatory.

Anyone ??? I'm hoping it's just residual bruising from the doorframe trauma. Could the one-arm pushups have exacerbated the bruising or is this likely a biceps tendon tear ? I can get down on the floor and do pushups right now. But I'm aware that most can do that with a partial tear.

[trufloridagator]

Could be a 1st, 2nd or 3rd degree. NSAIDs+Icing is good. You're going to see the ortho, so I wouldn't jump to anything more until you see what he says.

I've had a nagging 1st degree issues with tendonitis in the distal bicep tendon(lower one) in the past & had similar symptoms initially with very minor bruising, but the tendonitis continued & was the worst part of it.

Foam rolling or going to see a specialist for some ART helped me with the tendonitis and has been known to help with recovery from 1st or 2nd degree strains, but talk with your ortho.

Glad you're getting it taken care of, as to hopefully prevent any further issues or tendonitis/osis like I had.

[Dreamliner]

Could be a 1st, 2nd or 3rd degree. NSAIDs+Icing is good. You're going to see the ortho, so I wouldn't jump to anything more until you see what he says.

I've had a nagging 1st degree issues with tendonitis in the distal bicep tendon(lower one) in the past & had similar symptoms initially with very minor bruising, but the tendonitis continued & was the worst part of it.

Foam rolling or going to see a specialist for some ART helped me with the tendonitis and has been known to help with recovery from 1st or 2nd degree strains, but talk with your ortho.

Glad you're getting it taken care of, as to hopefully prevent any further issues or tendonitis/osis like I had.

Thanks for the encouragement. It's the bruising that's got me concerned. I'll keep you posted.

[LeafUF]

I dont know man but if it were me I would just think its from the slamming into door frame and probably nothing more.

I get bruises all the time so maybe I am just used to it so if I see a little purple or yellow here or there and it doesnt bother me too much I just move on with my life and let it heal.

[Dreamliner]

I dont know man but if it were me I would just think its from the slamming into door frame and probably nothing more.

I get bruises all the time so maybe I am just used to it so if I see a little purple or yellow here or there and it doesnt bother me too much I just move on with my life and let it heal.

Thanks, I'm hoping that's all it is. I may just ice and rest a couple of days, until the visible bruising subsides, then gingerly try some pushups. If that's no problem I'll probably call off the ortho.

[LoyalGatorFan]

Based on what you have said...I would lean towards bruising with a slight possibility you have a biceps tear secondary to the bruising....slamming your arm against a for is a compressive force...not a shear or torsion force which would cause tearing...you just bruised the muscle it sounds like...however, if you do pushups while the muscle is already injured/bleeding, it could lead to a tear because obviously the muscle is weaker since its injured and its not gonna be able to hold its normal capacity of weight/force....but usually a biceps tendon tear you will feel a pop or you can feel the tendon sublux on and off the head of the humerus where it attaches.....ortho still might get you an MRI to R/O the tear tho....

[LoyalGatorFan]

*slamming your arm against the door

And yes in the meantime I would do Ice, NSAIDS, and rest...if it hurts to move the arm I would even consider immobilization...

[LoyalGatorFan]

*slamming your arm against the door

And yes in the meantime I would do Ice, NSAIDS, and rest...if it hurts to move the arm I would even consider immobilization..

[orangeblueorangeblue]

If it were a biceps tendon tear you'd know it. There'd be no question.

[Dreamliner]

Just got back from the ortho. He initially suspected biceps tear but quickly ruled that out. He thinks I have a minor rotator-cuff tear and that the blunt trauma might have played a role. Says full-speed ahead on my workouts. He has no concerns about handstand pushups or one-arm pushup progressions, so long as they do not cause pain.

As an aside, as I'll be 55 in a couple of weeks, and have certainly abused my body, I feel like I'm a lucky guy. In the past year I've had x-rays of spine, knees and shoulder. All reveal optimal joint spacing. So, all of my aches and pains fall squarely under the 'Repetitive Strain' rubric.

Thanks for all the feedback and encouragement, folks.

[Dreamliner]

Based on what you have said...I would lean towards bruising with a slight possibility you have a biceps tear secondary to the bruising....slamming your arm against a for is a compressive force...not a shear or torsion force which would cause tearing...you just bruised the muscle it sounds like...however, if you do pushups while the muscle is already injured/bleeding, it could lead to a tear because obviously the muscle is weaker since its injured and its not gonna be able to hold its normal capacity of weight/force....but usually a biceps tendon tear you will feel a pop or you can feel the tendon sublux on and off the head of the humerus where it attaches.....ortho still might get you an MRI to R/O the tear tho....

Now that you mention it, I do feel an ever-so-slight sliding of a tendon. But it isn't painful and it predates the recent injury. This particular shoulder does have a bit of hyper-mobility though. The scapula also tips or wings on this side.

[LoyalGatorFan]

Now that you mention it, I do feel an ever-so-slight sliding of a tendon. But it isn't painful and it predates the recent injury. This particular shoulder does have a bit of hyper-mobility though. The scapula also tips or wings on this side.

Interesting....I need to brush up on my anatomy but 1 or 2 of the rotator cuff tendons do insert on the head of the humerus...I think to be more specific on the greater tubercle/trochanter....I think supraspinatus inserts on the greater and infraspinatus on the lesser..I have to double check...but either way if you have a cuff tear that could very well be the tendon that is subluxing off the bone....

As far as winged scapula, that usually indicates 1 of 2 things...either you have an injury to the long thoracic nerve (which pierces the serratus anterior muscle) or you just have weak serratus anteriors....a good way to strengthen those which you are already doing is pushups....maybe you could do more reps or progress to more advanced pushups as long as pain is not a factor....if you don't wanna do pushups you can practice wall punches...either doing isometrics where you press your fist against a wall with the arm fulling extended or you can even take up punching bag lessons....

[Dreamliner]

Interesting....I need to brush up on my anatomy but 1 or 2 of the rotator cuff tendons do insert on the head of the humerus...I think to be more specific on the greater tubercle/trochanter....I think supraspinatus inserts on the greater and infraspinatus on the lesser..I have to double check...but either way if you have a cuff tear that could very well be the tendon that is subluxing off the bone....

As far as winged scapula, that usually indicates 1 of 2 things...either you have an injury to the long thoracic nerve (which pierces the serratus anterior muscle) or you just have weak serratus anteriors....a good way to strengthen those which you are already doing is pushups....maybe you could do more reps or progress to more advanced pushups as long as pain is not a factor....if you don't wanna do pushups you can practice wall punches...either doing isometrics where you press your fist against a wall with the arm fulling extended or you can even take up punching bag lessons....

Thanks for the feedback, Loyal. I'm doing two things to try to shore up the scapula:

(1) I push that little bit extra at the top when doing pushups, protracting the shoulder blades so as to get the serratus anterior.

(2) I pull down and back on pullups and inverted rows to hit the lower traps. I also think about driving my elbows to my sides on pullups rather than worrying about getting my chin over the bar.

As to pushups, I was actually doing one-armed pushup progressions leading up to the discovery of the bruising. Friday is my next schedule day for the one-arms. So, if I experience any marked discomfort with them I'll probably just regress to standard pushups.

Are you a PT ? Chiro ?

[LoyalGatorFan]

Yeah it sounds like you're either a CPT or CSCS or some sort of personal trainer...I am sure you pretty much know what you're doing and how to handle your body tolerances...wall pushups are good for serratus anterior strengthening...they don't seem to cause any discomfort with the athletes/patients I have had who performed them...

And I am an athletic trainer and massage therapist....never dealt or worked with chiros but I have plenty of experience with PTs.....

[Dreamliner]

Yeah it sounds like you're either a CPT or CSCS or some sort of personal trainer...I am sure you pretty much know what you're doing and how to handle your body tolerances...wall pushups are good for serratus anterior strengthening...they don't seem to cause any discomfort with the athletes/patients I have had who performed them...

And I am an athletic trainer and massage therapist....never dealt or worked with chiros but I have plenty of experience with PTs.....

Yeah, I'm 'some sort of trainer.' :wink: I'm studying for my CPT-ACSM but have been training people for awhile.

I've also been working to correct a fairly prominent case of kyphosis and forward head. The former has improved significantly and the latter marginally. I try to take a global approach to aches and pains. And I suspect all these measures go to provide more 'breathing room' for the rotator cuff.

[GatorLegend]

Trufloridagator said, " Foam rolling or going to a specialist for some ART". I'm also experiencing tennis elbow or tendonitis. Anyone know what Trufloridagator is refering to?

[LeafUF]

Trufloridagator said, " Foam rolling or going to a specialist for some ART". I'm also experiencing tennis elbow or tendonitis. Anyone know what Trufloridagator is refering to?

Foam rolling is just using a foam roller to stretch out muscles and loosen up. The foam roller is usually pretty stiff and its often not the most comfortable thing in the world but it is supposed to great for you. ART is active release therapy, I dont know much about it, I think it is some sort of massage for sports injuries? Probably more complex than that.

[GatorLegend]

Thanks, Leaf.

[breezergator]

Can you throw a ball overhand ten times without failure or discomfort ?

[Dreamliner]

Can you throw a ball overhand ten times without failure or discomfort ?

I don't know. But I just got through doing handstand pushups. Only a slight twinge, and then only at the beginning of the set when I'm setting my shoulders. At my appointment today, on the way out, the ortho told me that if I can do handstand pushups then there can't be anything seriously wrong with the shoulder. And he did all the range-of-motion tests, etc. I'm going to trust him on this and push ahead. It's not in my makeup to back off if I don't have to.

[LoyalGatorFan]

Trufloridagator said, " Foam rolling or going to a specialist for some ART". I'm also experiencing tennis elbow or tendonitis. Anyone know what Trufloridagator is refering to?

In your situation, you could use a lot of ice and rest...I know the rest part is probably hard for you to do if you're fairly active...the occasional anti-inflam can help as well....in the meantime, be sure you stretch your forearm extensor and flexor muscles...all you have to do is bend your wrist back/extend and push to stretch the underside of the forearm (flexors) and for the extensors its the opposite...bend the wrist down as far as it can go and give a push on the hand at the end...

ART is a manual therapy treatment..can be incorporated in massage or physical therapy...there are various methods...one can be just static compression over a tight muscle until you can get it to relax....another could be compression of the muscle followed by a stretch....

[LoyalGatorFan]

Yeah, I'm 'some sort of trainer.' :wink: I'm studying for my CPT-ACSM but have been training people for awhile.

I've also been working to correct a fairly prominent case of kyphosis and forward head. The former has improved significantly and the latter marginally. I try to take a global approach to aches and pains. And I suspect all these measures go to provide more 'breathing room' for the rotator cuff.

Yeah I get a lot of kyphosis and FHP clients at the massage clinic...I usually tell them to strengthen the neck/upper back and stretch the front (ant. delts, pecs, scalenes) to bring the shoulders back...yeah so for you make sure you stretch delts, pecs, scalenes, biceps, etc...any muscle that attaches to the shoulder or clavicle basically...

[Dreamliner]

Loyal, glad you found the forum and I for one appreciate your contributions.

[fbgator27]

Thanks for the feedback, Loyal. I'm doing two things to try to shore up the scapula:

(1) I push that little bit extra at the top when doing pushups, protracting the shoulder blades so as to get the serratus anterior.

(2) I pull down and back on pullups and inverted rows to hit the lower traps. I also think about driving my elbows to my sides on pullups rather than worrying about getting my chin over the bar.

As to pushups, I was actually doing one-armed pushup progressions leading up to the discovery of the bruising. Friday is my next schedule day for the one-arms. So, if I experience any marked discomfort with them I'll probably just regress to standard pushups.

Are you a PT ? Chiro ?




Sounds like you are hitting the scap stabilizers pretty well. But if you are noticing your winging at rest while not using your arm your not really catching the whole picture. Serratus is not a postural muscle that actively contracts to hold your blade to your rib cage at rest (ie. while you are standing in the mirror looking at yourself). I would check it while doing some dynamic activities to get a better idea if your firing the muscle well. If you notice winging at rest I would look more towards things like tight pec minor, a rounded back posture, or even a guarded serratus anterior.


Just another thought since you mention anterior shoulder pain and handstand pushups and one arm pushups. Its possible that you are impinging the coracoid on the humerus. If you notice the pain with these activities try turning your hands out a little and see if this makes a difference. Overhead activity with internal rotation of the shoulder could cause either the biceps or lesser tuberosity to rub the coracoid.

[Dreamliner]

Sounds like you are hitting the scap stabilizers pretty well. But if you are noticing your winging at rest while not using your arm your not really catching the whole picture. Serratus is not a postural muscle that actively contracts to hold your blade to your rib cage at rest (ie. while you are standing in the mirror looking at yourself). I would check it while doing some dynamic activities to get a better idea if your firing the muscle well. If you notice winging at rest I would look more towards things like tight pec minor, a rounded back posture, or even a guarded serratus anterior.


Just another thought since you mention anterior shoulder pain and handstand pushups and one arm pushups. Its possible that you are impinging the coracoid on the humerus. If you notice the pain with these activities try turning your hands out a little and see if this makes a difference. Overhead activity with internal rotation of the shoulder could cause either the biceps or lesser tuberosity to rub the coracoid.

Pec minor does tend to be tight but scap does not wing at rest. I discovered the wisdom of turning hands out quite by accident. It seems to shorten ROM during pushups and prompts me to keep my elbows somewhat tucked on both HSPU's and pushups which seems to be better for my shoulders.

But yes, the scap does wing during pushups UNLESS I consciously work to keep it retracted. But I must confess that it's VERY difficult to keep it quiet during OAP's. However, I've temporarily taken to performing them in front of a full-length mirror. No, I don't like the fact that I have to look up, but at least the mirror indicates that if I labor to keep everything tight, and the working shoulder stable, elbow tucked, and stop short of chest-to-floor, the scap remains at least better retracted. Certainly one of the keys is not to go crazy on range-of-motion and to work within my true strength capacities.

Also, while examining the x-rays, the ortho said, "Your AC looks good. Your rotator cuff has plenty of room."

[Dreamliner]

Shoulder isn't feeling too bad after yesterday's handstand pushups. Still, to hedge my bets, I may go to an upper-lower split so as to allow more recovery for the shoulders and knees. It may make more sense to do all the pressing in one workout.